Integrating bedside nurses into antibiotic stewardship: A practical approach

Elizabeth A. Monsees, Pranita Tamma, Sara Cosgrove, Melissa A. Miller, Maria Valeria Fabre

Research output: Contribution to journalReview article

Abstract

Nurses view patient safety as an essential component of their work and have reported a general interest in embracing an antibiotic steward role. However, antibiotic stewardship (AS) functions have not been formally integrated into nursing practice despite nurses' daily involvement in clinical activities that impact antibiotic decisions (e.g., obtaining specimens for cultures, blood drawing for therapeutic drug monitoring). Recommendations to expand AS programs to include bedside nurses are generating support at a national level, yet a practical guidance on how nurses can be involved in AS activities is lacking. In this review, we provide a framework identifying selected practices where nurses can improve antibiotic prescribing practices through appropriate obtainment of Clostridioides difficile tests, appropriate urine culturing practices, optimal antibiotic administration, accurate and detailed documentation of penicillin allergy histories and through the prompting of antibiotic time outs. We identify reported barriers to engagement of nurses in AS and offer potential solutions that include patient safety principles and quality improvement strategies that can be used to mitigate participation barriers. This review will assist AS leaders interested in advancing the contributions of nurses into their AS programs by discussing education, communication, improvement models, and workflow integration enhancements that strengthen systems to support nurses as valued partners in AS efforts.

Original languageEnglish (US)
JournalInfection control and hospital epidemiology
DOIs
StatePublished - Jan 1 2019

Fingerprint

Nurses
Anti-Bacterial Agents
Patient Safety
Workflow
Drug Monitoring
Quality Improvement
Penicillins
Documentation
Hypersensitivity
Nursing
Communication
Urine
Education

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Integrating bedside nurses into antibiotic stewardship : A practical approach. / Monsees, Elizabeth A.; Tamma, Pranita; Cosgrove, Sara; Miller, Melissa A.; Fabre, Maria Valeria.

In: Infection control and hospital epidemiology, 01.01.2019.

Research output: Contribution to journalReview article

@article{d3d3bb0cad784fcaa74db0ef80d25646,
title = "Integrating bedside nurses into antibiotic stewardship: A practical approach",
abstract = "Nurses view patient safety as an essential component of their work and have reported a general interest in embracing an antibiotic steward role. However, antibiotic stewardship (AS) functions have not been formally integrated into nursing practice despite nurses' daily involvement in clinical activities that impact antibiotic decisions (e.g., obtaining specimens for cultures, blood drawing for therapeutic drug monitoring). Recommendations to expand AS programs to include bedside nurses are generating support at a national level, yet a practical guidance on how nurses can be involved in AS activities is lacking. In this review, we provide a framework identifying selected practices where nurses can improve antibiotic prescribing practices through appropriate obtainment of Clostridioides difficile tests, appropriate urine culturing practices, optimal antibiotic administration, accurate and detailed documentation of penicillin allergy histories and through the prompting of antibiotic time outs. We identify reported barriers to engagement of nurses in AS and offer potential solutions that include patient safety principles and quality improvement strategies that can be used to mitigate participation barriers. This review will assist AS leaders interested in advancing the contributions of nurses into their AS programs by discussing education, communication, improvement models, and workflow integration enhancements that strengthen systems to support nurses as valued partners in AS efforts.",
author = "Monsees, {Elizabeth A.} and Pranita Tamma and Sara Cosgrove and Miller, {Melissa A.} and Fabre, {Maria Valeria}",
year = "2019",
month = "1",
day = "1",
doi = "10.1017/ice.2018.362",
language = "English (US)",
journal = "Infection Control and Hospital Epidemiology",
issn = "0899-823X",
publisher = "University of Chicago Press",

}

TY - JOUR

T1 - Integrating bedside nurses into antibiotic stewardship

T2 - A practical approach

AU - Monsees, Elizabeth A.

AU - Tamma, Pranita

AU - Cosgrove, Sara

AU - Miller, Melissa A.

AU - Fabre, Maria Valeria

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Nurses view patient safety as an essential component of their work and have reported a general interest in embracing an antibiotic steward role. However, antibiotic stewardship (AS) functions have not been formally integrated into nursing practice despite nurses' daily involvement in clinical activities that impact antibiotic decisions (e.g., obtaining specimens for cultures, blood drawing for therapeutic drug monitoring). Recommendations to expand AS programs to include bedside nurses are generating support at a national level, yet a practical guidance on how nurses can be involved in AS activities is lacking. In this review, we provide a framework identifying selected practices where nurses can improve antibiotic prescribing practices through appropriate obtainment of Clostridioides difficile tests, appropriate urine culturing practices, optimal antibiotic administration, accurate and detailed documentation of penicillin allergy histories and through the prompting of antibiotic time outs. We identify reported barriers to engagement of nurses in AS and offer potential solutions that include patient safety principles and quality improvement strategies that can be used to mitigate participation barriers. This review will assist AS leaders interested in advancing the contributions of nurses into their AS programs by discussing education, communication, improvement models, and workflow integration enhancements that strengthen systems to support nurses as valued partners in AS efforts.

AB - Nurses view patient safety as an essential component of their work and have reported a general interest in embracing an antibiotic steward role. However, antibiotic stewardship (AS) functions have not been formally integrated into nursing practice despite nurses' daily involvement in clinical activities that impact antibiotic decisions (e.g., obtaining specimens for cultures, blood drawing for therapeutic drug monitoring). Recommendations to expand AS programs to include bedside nurses are generating support at a national level, yet a practical guidance on how nurses can be involved in AS activities is lacking. In this review, we provide a framework identifying selected practices where nurses can improve antibiotic prescribing practices through appropriate obtainment of Clostridioides difficile tests, appropriate urine culturing practices, optimal antibiotic administration, accurate and detailed documentation of penicillin allergy histories and through the prompting of antibiotic time outs. We identify reported barriers to engagement of nurses in AS and offer potential solutions that include patient safety principles and quality improvement strategies that can be used to mitigate participation barriers. This review will assist AS leaders interested in advancing the contributions of nurses into their AS programs by discussing education, communication, improvement models, and workflow integration enhancements that strengthen systems to support nurses as valued partners in AS efforts.

UR - http://www.scopus.com/inward/record.url?scp=85061983568&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85061983568&partnerID=8YFLogxK

U2 - 10.1017/ice.2018.362

DO - 10.1017/ice.2018.362

M3 - Review article

C2 - 30786944

AN - SCOPUS:85061983568

JO - Infection Control and Hospital Epidemiology

JF - Infection Control and Hospital Epidemiology

SN - 0899-823X

ER -